title: A gender-specific analysis of association between hyperuricaemia and cardiovascular events in patients with coronary artery disease.
abstract: OBJECTIVE
  Gender-related differences in the association between hyperuricaemia and cardiovascular events remain poorly understood. The objective of this study was to assess gender-related differences in the association between hyperuricaemia and cardiovascular events in patients with coronary artery disease (CAD).
  
  
  RESULTS
  This study included 13,273 patients with CAD. Hyperuricaemia was defined as a plasma uric acid >7.0mgdl(-1) in men and >5.7mgdl(-1) in women. The primary outcome was 1-year all-cause mortality. Hyperuricaemia was found in 3745 men (36.5%) and 1562 women (50.3%); odds ratio (OR)=1.76, 95% confidence interval (CI) 1.62-1.91; P<0.001. Women with hyperuricaemia were older, had higher proportions of patients with diabetes and arterial hypertension and had reduced renal function and higher C-reactive protein levels compared with men with hyperuricaemia. One-year all-cause mortality was 9.3% (n=143) in women with hyperuricaemia versus 6.9% (n = 252) in men with hyperuricaemia (P=0.002). After adjustment in multivariable Cox proportional hazards model, uric acid predicted 1-year mortality with an adjusted hazard ratio (HR)=1.17, 95% CI (1.03-1.31), P=0.012 in men and HR=1.25, 95% CI (1.06-1.48), P=0.007 in women, for each standard deviation increase in the natural logarithm. Uric acid predicted 1-year mortality with an area under the receiver-operating characteristic curve=0.625, 95% CI (0.594-0.656) in men and 0.676, 95% CI (0.635-0.717) in women (P=0.044, for women versus men).
  
  
  CONCLUSIONS
  Hyperuricaemia predicts an increased risk of 1-year mortality in both genders with a stronger association in women. Differences in cardiovascular risk profile may explain the stronger association between hyperuricaemia and cardiovascular events in women.
authors.affiliation: Deutsches Herzzentrum, Technische Universität, Lazarettstrasse 36, 80636 Munich, Germany. Electronic address: ndrepepa@dhm.mhn.de.
authors.forename: G
authors.initials: G
authors.lastname: Ndrepepa
authors.forename: S
authors.initials: S
authors.lastname: Cassese
authors.forename: S
authors.initials: S
authors.lastname: Braun
authors.forename: M
authors.initials: M
authors.lastname: Fusaro
authors.forename: L
authors.initials: L
authors.lastname: King
authors.forename: T
authors.initials: T
authors.lastname: Tada
authors.forename: A
authors.initials: A
authors.lastname: Schömig
authors.forename: A
authors.initials: A
authors.lastname: Kastrati
authors.forename: R
authors.initials: R
authors.lastname: Schmidt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000150:complications / Q000401:mortality; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000401:mortality; D033461:Hyperuricemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012372:ROC Curve; D012307:Risk Factors; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood; D014527:Uric Acid / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D014527:Uric Acid; D002097:C-Reactive Protein
keywords: Cardiovascular risk; Gender; Hyperuricaemia; Mortality